Job Title: Medical Management Consultants
Salary: R30 000 Per Month
Location: South Africa
Job Type: 3 Year Fixed Term Contract
The Road Accident Fund (RAF) invites suitably qualified applicants to apply for their Medical Management Consultant Vacancies (X20 Posts). The closing date for applications is the 15th October 2025
POSITIONS: CONSULTANT: MEDICAL MANAGEMENT X20
QUALIFICATIONS & EXPERIENCE:
Qualification
- Bachelor’s Degree/Advanced Diploma in Health Sciences/Medical related qualification.
- Registration with HPCSA/SANCA.
- Relevant 3 years’ experience in A Medical related environment.
KEY PERFORMANCE AREAS
Medical Management
- Conduct medical assessment and compile injury assessment reports.
- Conduct assessments and bill reviews on submitted claims, focusing on the appropriate level of care, the length of stay and quality of care.
- Incorporate tariffs, cost savings initiative recording and treatment protocol to ensure that all service providers adhere to the rules and the tariff as guided by the RAF and/or any that is considered reasonable.
- Pre-authorise submitted claims aligned to RAF clinical guidelines including the RAF formulary treatment protocols and related tariffs.
- Escalation of complex cases for multi-disciplinary review and adjudication.
- Participate in the consultations process on the implementation of medical claims processes.
Reporting
- Track and report against set objectives and targets.
- Report on emerging risks.
- Provide ad-hoc reports on process improvement initiatives.
- Produce documents, briefing papers, reports and presentations
Stakeholder management
- Deal with/and respond to correspondence.
- Maintain healthy relationships with all stakeholders.
- Follow up and making recommendations on which corrective actions are appropriate.
- Follow up and feedback to all stakeholders to keep them updated on the status of a query.
- Respond to queries within the predefined turnaround times.
Technical and behavioral competencies required
- Claims management process/processes and systems.
- Medical product management.
- Medical bill reviewing
- Medical case management
CLICK HERE TO APPLY FOR THE CONSULTANT: MEDICAL MANAGEMENT X2o
CLOSING DATE: 15 OCTOBER 2025